Kasamatsu, T; Cleary, M; Bennett, J; Howard, K; McLeod, T V
Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 153–161, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires
@article{Kasamatsu2016a,
title = {Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer},
author = {Kasamatsu, T and Cleary, M and Bennett, J and Howard, K and McLeod, T V},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {153--161},
abstract = {CONTEXT: Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools. OBJECTIVE: To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 1124 secondary school ATs completed the survey (28.5% response rate). The majority of participants were employed full time (752/1114 [67.5%]) in public schools (911/1117 [81.6%]). MAIN OUTCOME MEASURE(S): School and AT employment characteristics, demographics, number of concussions evaluated annually, and perceptions of school professionals' familiarity with ATs' responsibilities were independent variables. RESULTS: Of the ATs, 44% reported having an existing return-to-learn policy. The strongest predictor of a return-to-learn policy was frequent communication with teachers after concussion (odds ratio = 1.5; 95% confidence interval = 1.2, 1.7). Most ATs recommended complete cognitive rest (eg, no reading, television; 492/1087 [45.3%]) or limited cognitive activity based upon symptoms (391/1087 [36.0%]). Common academic accommodations were postponed due dates (789/954 [82.7%]), rest breaks (765/954 [80.2%]), and partial attendance (740/954 [77.6%]). Athletic trainers self-reported as primary monitors of health (764/1037 [73.7%]) and academic progression (359/1011 [35.5%]). The strongest predictor of ATs' communication with school professionals was their perception of school professionals' understanding of ATs' roles. CONCLUSIONS: Overall, ATs followed best practices for cognitive rest and return to learn after concussion. Although ATs are central to the management of student-athletes' physical health after concussion, school professionals may be better suited to monitor academic progress. Increased communication between the AT and school professionals is recommended to monitor recovery and facilitate academic support for symptomatic student-athletes.},
keywords = {*Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
Abstract | BibTeX | Tags: *Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {*Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {*Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Kurowski, B G; Pomerantz, W J; Schaiper, C; Ho, M; Gittelman, M A
Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 3 Suppl 1, pp. S21–8, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/pc [Prevention & Control], *Brain Concussion/pc [Prevention & Control], *Health Education, *Health Knowledge, Adolescent, Attitudes, Case-Control Studies, Educational Measurement, Female, Humans, Male, Practice, Prospective Studies, Surveys and Questionnaires
@article{Kurowski2015,
title = {Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes},
author = {Kurowski, B G and Pomerantz, W J and Schaiper, C and Ho, M and Gittelman, M A},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {3 Suppl 1},
pages = {S21--8},
abstract = {BACKGROUND: The benefit of preseason concussion education on athletes' knowledge, attitudes, and behaviors is unclear. The purpose of the study was to determine the influence of preseason concussion education on knowledge and self-reported attitudes and reporting behaviors. We hypothesized that preseason education would lead to better knowledge and self-reported attitudes and better reporting of concussion symptoms during the season. METHODS: This study involved a prospective cohort comparing the benefits of a preseason lectured-based concussion education session at one high school with a control school. Participants included males and females age 13 years to 18 years from two community high schools who were participating in higher concussion risk, fall or winter sports (football, soccer, wrestling, and basketball). The education school and control school included 234 and 262 participants, respectively. Outcomes were a preseason and postseason survey assessing knowledge and self-reported attitudes about concussions and an end-of-season questionnaire assessing concussion reporting behaviors during the season. RESULTS: Total scores on the combined (p \< 0.0001), knowledge-based (p = 0.016), and behavioral-based (p \< 0.0001) questions demonstrated statistically significant improvement in the education group. Scores peaked immediately after education but dissipated at the end of the season. There was a lower proportion in the education school (72%) compared with the control school (88%) that reported continued play despite having concussion symptoms during the season (p = 0.025). A similar proportion of athletes diagnosed with concussion during the season in the education (27%) and control schools (23%) reported returning to play before symptoms resolved (p = 0.81). CONCLUSION: These findings suggest that a didactic-based preseason concussion education likely has minimal benefits. Other factors besides knowledge are likely influencing student-athlete concussion reporting behavior. Future research focused on changing the culture of concussion reporting is needed. LEVEL OF EVIDENCE: Therapeutic study, level III.},
keywords = {*Athletic Injuries/pc [Prevention \& Control], *Brain Concussion/pc [Prevention \& Control], *Health Education, *Health Knowledge, Adolescent, Attitudes, Case-Control Studies, Educational Measurement, Female, Humans, Male, Practice, Prospective Studies, Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Buckley, T A; Burdette, G; Kelly, K
Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives Journal Article
In: Journal of Athletic Training, vol. 50, no. 8, pp. 879–888, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires
@article{Buckley2015,
title = {Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives},
author = {Buckley, T A and Burdette, G and Kelly, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Athletic Training},
volume = {50},
number = {8},
pages = {879--888},
abstract = {CONTEXT: The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. OBJECTIVE: To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. MAIN OUTCOME MEASURE(S): The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. RESULTS: Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%},
keywords = {*Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Nauman, E A; Breedlove, K M; Breedlove, E L; Talavage, T M; Robinson, M E; Leverenz, L J
Post-Season Neurophysiological Deficits Assessed by ImPACT and fMRI in Athletes Competing in American Football Journal Article
In: Developmental Neuropsychology, vol. 40, no. 2, pp. 85–91, 2015.
Abstract | BibTeX | Tags: *Athletes, *Brain Concussion/pp [Physiopathology], *Football/in [Injuries], *MAGNETIC resonance imaging, Adolescent, Brain Concussion/pa [Pathology], Head, Humans, Male, Neurophysiology, Neuropsychological Tests, Schools, Seasons, Surveys and Questionnaires, UNITED States, Young Adult
@article{Nauman2015,
title = {Post-Season Neurophysiological Deficits Assessed by ImPACT and fMRI in Athletes Competing in American Football},
author = {Nauman, E A and Breedlove, K M and Breedlove, E L and Talavage, T M and Robinson, M E and Leverenz, L J},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {2},
pages = {85--91},
abstract = {Neurocognitive assessment, functional magnetic resonance imaging, and head impact monitoring were used to evaluate neurological changes in high school football players throughout competitive seasons. A substantial number of asymptomatic athletes exhibited neurophysiological changes that persisted post-season, with abnormal measures significantly more common in athletes receiving 50 or more hits per week during the season.},
keywords = {*Athletes, *Brain Concussion/pp [Physiopathology], *Football/in [Injuries], *MAGNETIC resonance imaging, Adolescent, Brain Concussion/pa [Pathology], Head, Humans, Male, Neurophysiology, Neuropsychological Tests, Schools, Seasons, Surveys and Questionnaires, UNITED States, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Zottoli, T M; Hoover, S; Barr, W B
In: Clinical Neuropsychologist, vol. 29, no. 5, pp. 678–688, 2015.
Abstract | Links | BibTeX | Tags: brain concussion, Civil Litigation, Female, human, Humans, IME, Insufficient effort, legislation and jurisprudence, Male, malingering, Malpractice, middle aged, neuropsychological test, Neuropsychological Tests, neuropsychology, Physical Examination, questionnaire, Standardized assessment of concussion (SAC), statistics and numerical data, Surveys and Questionnaires
@article{Zottoli2015,
title = {Utility of the Standardized Assessment of Concussion (SAC) to Detect Insufficient Effort in Independent Medical Examinations and Civil Litigation Cases},
author = {Zottoli, T M and Hoover, S and Barr, W B},
doi = {10.1080/13854046.2015.1062562},
year = {2015},
date = {2015-01-01},
journal = {Clinical Neuropsychologist},
volume = {29},
number = {5},
pages = {678--688},
abstract = {Objective: The Standardized Assessment of Concussion (SAC) is a standardized mental status screening instrument initially developed for assessment and tracking of concussion symptoms in athletes. The purpose of the current study was to validate the utility of the SAC as an embedded screening measure for insufficient effort in independent medical examinations (IME) and personal injury cases. Method: A known-groups design was used to examine the SACs utility for the detection of insufficient effort in 75 de-identified private IME and civil litigation evaluations. Initial classifications of insufficient effort were made independently of SAC scores, on the basis of having two or more scores falling below established cut-offs on previously validated neuropsychological measures. Results: Results suggest that the total score on the SAC significantly distinguishes effortful respondents from those exhibiting insufficient effort. Empirically derived cut-off scores yielded adequate sensitivity (.62-.95) and negative predictive power (.93-.97). Conclusions: While optimal cut-off scores depend upon intended use, our data suggest that the SAC is useful as a potential screener for insufficient effort, after which one can employ additional measures to rule out false-positives. Further research is required before cut-off scores can be recommended for clinical use. © 2015 Taylor and Francis.},
keywords = {brain concussion, Civil Litigation, Female, human, Humans, IME, Insufficient effort, legislation and jurisprudence, Male, malingering, Malpractice, middle aged, neuropsychological test, Neuropsychological Tests, neuropsychology, Physical Examination, questionnaire, Standardized assessment of concussion (SAC), statistics and numerical data, Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Thornton, A E; Cox, D N; Whitfield, K; Fouladi, R T
Cumulative concussion exposure in rugby players: neurocognitive and symptomatic outcomes Journal Article
In: Journal of Clinical & Experimental Neuropsychology, vol. 30, no. 4, pp. 398–409, 2008.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *COGNITION, *Cognition Disorders/et [Etiology], *Football/in [Injuries], adult, Age Factors, aged, Brain Concussion/di [Diagnosis], Female, Humans, Male, middle aged, Neuropsychological Tests, Predictive Value of Tests, REGRESSION analysis, Surveys and Questionnaires, Trauma Severity Indices
@article{Thornton2008a,
title = {Cumulative concussion exposure in rugby players: neurocognitive and symptomatic outcomes},
author = {Thornton, A E and Cox, D N and Whitfield, K and Fouladi, R T},
year = {2008},
date = {2008-01-01},
journal = {Journal of Clinical \& Experimental Neuropsychology},
volume = {30},
number = {4},
pages = {398--409},
abstract = {A total of 111 rugby players underwent comprehensive testing to determine the impact of self-reported concussion exposure. Reliable estimates of concussion exposure were associated with an increase in postconcussion symptoms (PCS), but not diminished neurocognitive functioning. Importantly, the effects of concussion exposure on PCS varied as a function of player status. More specifically, extent of concussion exposure was associated with increased memory complaints and overall PCS endorsements in a dose-dependent manner for retired and older recreational players, but not for those who were younger and playing at more competitive levels. Future work should systematically evaluate the constituent participant factors that may influence differential concussion outcomes.},
keywords = {*Brain Concussion/co [Complications], *COGNITION, *Cognition Disorders/et [Etiology], *Football/in [Injuries], adult, Age Factors, aged, Brain Concussion/di [Diagnosis], Female, Humans, Male, middle aged, Neuropsychological Tests, Predictive Value of Tests, REGRESSION analysis, Surveys and Questionnaires, Trauma Severity Indices},
pubstate = {published},
tppubtype = {article}
}
Kasamatsu, T; Cleary, M; Bennett, J; Howard, K; McLeod, T V
Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 153–161, 2016.
@article{Kasamatsu2016a,
title = {Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer},
author = {Kasamatsu, T and Cleary, M and Bennett, J and Howard, K and McLeod, T V},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {153--161},
abstract = {CONTEXT: Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools. OBJECTIVE: To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 1124 secondary school ATs completed the survey (28.5% response rate). The majority of participants were employed full time (752/1114 [67.5%]) in public schools (911/1117 [81.6%]). MAIN OUTCOME MEASURE(S): School and AT employment characteristics, demographics, number of concussions evaluated annually, and perceptions of school professionals' familiarity with ATs' responsibilities were independent variables. RESULTS: Of the ATs, 44% reported having an existing return-to-learn policy. The strongest predictor of a return-to-learn policy was frequent communication with teachers after concussion (odds ratio = 1.5; 95% confidence interval = 1.2, 1.7). Most ATs recommended complete cognitive rest (eg, no reading, television; 492/1087 [45.3%]) or limited cognitive activity based upon symptoms (391/1087 [36.0%]). Common academic accommodations were postponed due dates (789/954 [82.7%]), rest breaks (765/954 [80.2%]), and partial attendance (740/954 [77.6%]). Athletic trainers self-reported as primary monitors of health (764/1037 [73.7%]) and academic progression (359/1011 [35.5%]). The strongest predictor of ATs' communication with school professionals was their perception of school professionals' understanding of ATs' roles. CONCLUSIONS: Overall, ATs followed best practices for cognitive rest and return to learn after concussion. Although ATs are central to the management of student-athletes' physical health after concussion, school professionals may be better suited to monitor academic progress. Increased communication between the AT and school professionals is recommended to monitor recovery and facilitate academic support for symptomatic student-athletes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kurowski, B G; Pomerantz, W J; Schaiper, C; Ho, M; Gittelman, M A
Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 3 Suppl 1, pp. S21–8, 2015.
@article{Kurowski2015,
title = {Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes},
author = {Kurowski, B G and Pomerantz, W J and Schaiper, C and Ho, M and Gittelman, M A},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {3 Suppl 1},
pages = {S21--8},
abstract = {BACKGROUND: The benefit of preseason concussion education on athletes' knowledge, attitudes, and behaviors is unclear. The purpose of the study was to determine the influence of preseason concussion education on knowledge and self-reported attitudes and reporting behaviors. We hypothesized that preseason education would lead to better knowledge and self-reported attitudes and better reporting of concussion symptoms during the season. METHODS: This study involved a prospective cohort comparing the benefits of a preseason lectured-based concussion education session at one high school with a control school. Participants included males and females age 13 years to 18 years from two community high schools who were participating in higher concussion risk, fall or winter sports (football, soccer, wrestling, and basketball). The education school and control school included 234 and 262 participants, respectively. Outcomes were a preseason and postseason survey assessing knowledge and self-reported attitudes about concussions and an end-of-season questionnaire assessing concussion reporting behaviors during the season. RESULTS: Total scores on the combined (p \< 0.0001), knowledge-based (p = 0.016), and behavioral-based (p \< 0.0001) questions demonstrated statistically significant improvement in the education group. Scores peaked immediately after education but dissipated at the end of the season. There was a lower proportion in the education school (72%) compared with the control school (88%) that reported continued play despite having concussion symptoms during the season (p = 0.025). A similar proportion of athletes diagnosed with concussion during the season in the education (27%) and control schools (23%) reported returning to play before symptoms resolved (p = 0.81). CONCLUSION: These findings suggest that a didactic-based preseason concussion education likely has minimal benefits. Other factors besides knowledge are likely influencing student-athlete concussion reporting behavior. Future research focused on changing the culture of concussion reporting is needed. LEVEL OF EVIDENCE: Therapeutic study, level III.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Buckley, T A; Burdette, G; Kelly, K
Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives Journal Article
In: Journal of Athletic Training, vol. 50, no. 8, pp. 879–888, 2015.
@article{Buckley2015,
title = {Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives},
author = {Buckley, T A and Burdette, G and Kelly, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Athletic Training},
volume = {50},
number = {8},
pages = {879--888},
abstract = {CONTEXT: The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. OBJECTIVE: To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. MAIN OUTCOME MEASURE(S): The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. RESULTS: Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Nauman, E A; Breedlove, K M; Breedlove, E L; Talavage, T M; Robinson, M E; Leverenz, L J
Post-Season Neurophysiological Deficits Assessed by ImPACT and fMRI in Athletes Competing in American Football Journal Article
In: Developmental Neuropsychology, vol. 40, no. 2, pp. 85–91, 2015.
@article{Nauman2015,
title = {Post-Season Neurophysiological Deficits Assessed by ImPACT and fMRI in Athletes Competing in American Football},
author = {Nauman, E A and Breedlove, K M and Breedlove, E L and Talavage, T M and Robinson, M E and Leverenz, L J},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {2},
pages = {85--91},
abstract = {Neurocognitive assessment, functional magnetic resonance imaging, and head impact monitoring were used to evaluate neurological changes in high school football players throughout competitive seasons. A substantial number of asymptomatic athletes exhibited neurophysiological changes that persisted post-season, with abnormal measures significantly more common in athletes receiving 50 or more hits per week during the season.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Zottoli, T M; Hoover, S; Barr, W B
In: Clinical Neuropsychologist, vol. 29, no. 5, pp. 678–688, 2015.
@article{Zottoli2015,
title = {Utility of the Standardized Assessment of Concussion (SAC) to Detect Insufficient Effort in Independent Medical Examinations and Civil Litigation Cases},
author = {Zottoli, T M and Hoover, S and Barr, W B},
doi = {10.1080/13854046.2015.1062562},
year = {2015},
date = {2015-01-01},
journal = {Clinical Neuropsychologist},
volume = {29},
number = {5},
pages = {678--688},
abstract = {Objective: The Standardized Assessment of Concussion (SAC) is a standardized mental status screening instrument initially developed for assessment and tracking of concussion symptoms in athletes. The purpose of the current study was to validate the utility of the SAC as an embedded screening measure for insufficient effort in independent medical examinations (IME) and personal injury cases. Method: A known-groups design was used to examine the SACs utility for the detection of insufficient effort in 75 de-identified private IME and civil litigation evaluations. Initial classifications of insufficient effort were made independently of SAC scores, on the basis of having two or more scores falling below established cut-offs on previously validated neuropsychological measures. Results: Results suggest that the total score on the SAC significantly distinguishes effortful respondents from those exhibiting insufficient effort. Empirically derived cut-off scores yielded adequate sensitivity (.62-.95) and negative predictive power (.93-.97). Conclusions: While optimal cut-off scores depend upon intended use, our data suggest that the SAC is useful as a potential screener for insufficient effort, after which one can employ additional measures to rule out false-positives. Further research is required before cut-off scores can be recommended for clinical use. © 2015 Taylor and Francis.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Thornton, A E; Cox, D N; Whitfield, K; Fouladi, R T
Cumulative concussion exposure in rugby players: neurocognitive and symptomatic outcomes Journal Article
In: Journal of Clinical & Experimental Neuropsychology, vol. 30, no. 4, pp. 398–409, 2008.
@article{Thornton2008a,
title = {Cumulative concussion exposure in rugby players: neurocognitive and symptomatic outcomes},
author = {Thornton, A E and Cox, D N and Whitfield, K and Fouladi, R T},
year = {2008},
date = {2008-01-01},
journal = {Journal of Clinical \& Experimental Neuropsychology},
volume = {30},
number = {4},
pages = {398--409},
abstract = {A total of 111 rugby players underwent comprehensive testing to determine the impact of self-reported concussion exposure. Reliable estimates of concussion exposure were associated with an increase in postconcussion symptoms (PCS), but not diminished neurocognitive functioning. Importantly, the effects of concussion exposure on PCS varied as a function of player status. More specifically, extent of concussion exposure was associated with increased memory complaints and overall PCS endorsements in a dose-dependent manner for retired and older recreational players, but not for those who were younger and playing at more competitive levels. Future work should systematically evaluate the constituent participant factors that may influence differential concussion outcomes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kasamatsu, T; Cleary, M; Bennett, J; Howard, K; McLeod, T V
Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 153–161, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires
@article{Kasamatsu2016a,
title = {Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer},
author = {Kasamatsu, T and Cleary, M and Bennett, J and Howard, K and McLeod, T V},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {153--161},
abstract = {CONTEXT: Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools. OBJECTIVE: To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 1124 secondary school ATs completed the survey (28.5% response rate). The majority of participants were employed full time (752/1114 [67.5%]) in public schools (911/1117 [81.6%]). MAIN OUTCOME MEASURE(S): School and AT employment characteristics, demographics, number of concussions evaluated annually, and perceptions of school professionals' familiarity with ATs' responsibilities were independent variables. RESULTS: Of the ATs, 44% reported having an existing return-to-learn policy. The strongest predictor of a return-to-learn policy was frequent communication with teachers after concussion (odds ratio = 1.5; 95% confidence interval = 1.2, 1.7). Most ATs recommended complete cognitive rest (eg, no reading, television; 492/1087 [45.3%]) or limited cognitive activity based upon symptoms (391/1087 [36.0%]). Common academic accommodations were postponed due dates (789/954 [82.7%]), rest breaks (765/954 [80.2%]), and partial attendance (740/954 [77.6%]). Athletic trainers self-reported as primary monitors of health (764/1037 [73.7%]) and academic progression (359/1011 [35.5%]). The strongest predictor of ATs' communication with school professionals was their perception of school professionals' understanding of ATs' roles. CONCLUSIONS: Overall, ATs followed best practices for cognitive rest and return to learn after concussion. Although ATs are central to the management of student-athletes' physical health after concussion, school professionals may be better suited to monitor academic progress. Increased communication between the AT and school professionals is recommended to monitor recovery and facilitate academic support for symptomatic student-athletes.},
keywords = {*Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
Abstract | BibTeX | Tags: *Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {*Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {*Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Kurowski, B G; Pomerantz, W J; Schaiper, C; Ho, M; Gittelman, M A
Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 3 Suppl 1, pp. S21–8, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/pc [Prevention & Control], *Brain Concussion/pc [Prevention & Control], *Health Education, *Health Knowledge, Adolescent, Attitudes, Case-Control Studies, Educational Measurement, Female, Humans, Male, Practice, Prospective Studies, Surveys and Questionnaires
@article{Kurowski2015,
title = {Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes},
author = {Kurowski, B G and Pomerantz, W J and Schaiper, C and Ho, M and Gittelman, M A},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {3 Suppl 1},
pages = {S21--8},
abstract = {BACKGROUND: The benefit of preseason concussion education on athletes' knowledge, attitudes, and behaviors is unclear. The purpose of the study was to determine the influence of preseason concussion education on knowledge and self-reported attitudes and reporting behaviors. We hypothesized that preseason education would lead to better knowledge and self-reported attitudes and better reporting of concussion symptoms during the season. METHODS: This study involved a prospective cohort comparing the benefits of a preseason lectured-based concussion education session at one high school with a control school. Participants included males and females age 13 years to 18 years from two community high schools who were participating in higher concussion risk, fall or winter sports (football, soccer, wrestling, and basketball). The education school and control school included 234 and 262 participants, respectively. Outcomes were a preseason and postseason survey assessing knowledge and self-reported attitudes about concussions and an end-of-season questionnaire assessing concussion reporting behaviors during the season. RESULTS: Total scores on the combined (p \< 0.0001), knowledge-based (p = 0.016), and behavioral-based (p \< 0.0001) questions demonstrated statistically significant improvement in the education group. Scores peaked immediately after education but dissipated at the end of the season. There was a lower proportion in the education school (72%) compared with the control school (88%) that reported continued play despite having concussion symptoms during the season (p = 0.025). A similar proportion of athletes diagnosed with concussion during the season in the education (27%) and control schools (23%) reported returning to play before symptoms resolved (p = 0.81). CONCLUSION: These findings suggest that a didactic-based preseason concussion education likely has minimal benefits. Other factors besides knowledge are likely influencing student-athlete concussion reporting behavior. Future research focused on changing the culture of concussion reporting is needed. LEVEL OF EVIDENCE: Therapeutic study, level III.},
keywords = {*Athletic Injuries/pc [Prevention \& Control], *Brain Concussion/pc [Prevention \& Control], *Health Education, *Health Knowledge, Adolescent, Attitudes, Case-Control Studies, Educational Measurement, Female, Humans, Male, Practice, Prospective Studies, Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Buckley, T A; Burdette, G; Kelly, K
Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives Journal Article
In: Journal of Athletic Training, vol. 50, no. 8, pp. 879–888, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires
@article{Buckley2015,
title = {Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives},
author = {Buckley, T A and Burdette, G and Kelly, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Athletic Training},
volume = {50},
number = {8},
pages = {879--888},
abstract = {CONTEXT: The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. OBJECTIVE: To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. MAIN OUTCOME MEASURE(S): The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. RESULTS: Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%},
keywords = {*Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Nauman, E A; Breedlove, K M; Breedlove, E L; Talavage, T M; Robinson, M E; Leverenz, L J
Post-Season Neurophysiological Deficits Assessed by ImPACT and fMRI in Athletes Competing in American Football Journal Article
In: Developmental Neuropsychology, vol. 40, no. 2, pp. 85–91, 2015.
Abstract | BibTeX | Tags: *Athletes, *Brain Concussion/pp [Physiopathology], *Football/in [Injuries], *MAGNETIC resonance imaging, Adolescent, Brain Concussion/pa [Pathology], Head, Humans, Male, Neurophysiology, Neuropsychological Tests, Schools, Seasons, Surveys and Questionnaires, UNITED States, Young Adult
@article{Nauman2015,
title = {Post-Season Neurophysiological Deficits Assessed by ImPACT and fMRI in Athletes Competing in American Football},
author = {Nauman, E A and Breedlove, K M and Breedlove, E L and Talavage, T M and Robinson, M E and Leverenz, L J},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {2},
pages = {85--91},
abstract = {Neurocognitive assessment, functional magnetic resonance imaging, and head impact monitoring were used to evaluate neurological changes in high school football players throughout competitive seasons. A substantial number of asymptomatic athletes exhibited neurophysiological changes that persisted post-season, with abnormal measures significantly more common in athletes receiving 50 or more hits per week during the season.},
keywords = {*Athletes, *Brain Concussion/pp [Physiopathology], *Football/in [Injuries], *MAGNETIC resonance imaging, Adolescent, Brain Concussion/pa [Pathology], Head, Humans, Male, Neurophysiology, Neuropsychological Tests, Schools, Seasons, Surveys and Questionnaires, UNITED States, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Zottoli, T M; Hoover, S; Barr, W B
In: Clinical Neuropsychologist, vol. 29, no. 5, pp. 678–688, 2015.
Abstract | Links | BibTeX | Tags: brain concussion, Civil Litigation, Female, human, Humans, IME, Insufficient effort, legislation and jurisprudence, Male, malingering, Malpractice, middle aged, neuropsychological test, Neuropsychological Tests, neuropsychology, Physical Examination, questionnaire, Standardized assessment of concussion (SAC), statistics and numerical data, Surveys and Questionnaires
@article{Zottoli2015,
title = {Utility of the Standardized Assessment of Concussion (SAC) to Detect Insufficient Effort in Independent Medical Examinations and Civil Litigation Cases},
author = {Zottoli, T M and Hoover, S and Barr, W B},
doi = {10.1080/13854046.2015.1062562},
year = {2015},
date = {2015-01-01},
journal = {Clinical Neuropsychologist},
volume = {29},
number = {5},
pages = {678--688},
abstract = {Objective: The Standardized Assessment of Concussion (SAC) is a standardized mental status screening instrument initially developed for assessment and tracking of concussion symptoms in athletes. The purpose of the current study was to validate the utility of the SAC as an embedded screening measure for insufficient effort in independent medical examinations (IME) and personal injury cases. Method: A known-groups design was used to examine the SACs utility for the detection of insufficient effort in 75 de-identified private IME and civil litigation evaluations. Initial classifications of insufficient effort were made independently of SAC scores, on the basis of having two or more scores falling below established cut-offs on previously validated neuropsychological measures. Results: Results suggest that the total score on the SAC significantly distinguishes effortful respondents from those exhibiting insufficient effort. Empirically derived cut-off scores yielded adequate sensitivity (.62-.95) and negative predictive power (.93-.97). Conclusions: While optimal cut-off scores depend upon intended use, our data suggest that the SAC is useful as a potential screener for insufficient effort, after which one can employ additional measures to rule out false-positives. Further research is required before cut-off scores can be recommended for clinical use. © 2015 Taylor and Francis.},
keywords = {brain concussion, Civil Litigation, Female, human, Humans, IME, Insufficient effort, legislation and jurisprudence, Male, malingering, Malpractice, middle aged, neuropsychological test, Neuropsychological Tests, neuropsychology, Physical Examination, questionnaire, Standardized assessment of concussion (SAC), statistics and numerical data, Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Thornton, A E; Cox, D N; Whitfield, K; Fouladi, R T
Cumulative concussion exposure in rugby players: neurocognitive and symptomatic outcomes Journal Article
In: Journal of Clinical & Experimental Neuropsychology, vol. 30, no. 4, pp. 398–409, 2008.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *COGNITION, *Cognition Disorders/et [Etiology], *Football/in [Injuries], adult, Age Factors, aged, Brain Concussion/di [Diagnosis], Female, Humans, Male, middle aged, Neuropsychological Tests, Predictive Value of Tests, REGRESSION analysis, Surveys and Questionnaires, Trauma Severity Indices
@article{Thornton2008a,
title = {Cumulative concussion exposure in rugby players: neurocognitive and symptomatic outcomes},
author = {Thornton, A E and Cox, D N and Whitfield, K and Fouladi, R T},
year = {2008},
date = {2008-01-01},
journal = {Journal of Clinical \& Experimental Neuropsychology},
volume = {30},
number = {4},
pages = {398--409},
abstract = {A total of 111 rugby players underwent comprehensive testing to determine the impact of self-reported concussion exposure. Reliable estimates of concussion exposure were associated with an increase in postconcussion symptoms (PCS), but not diminished neurocognitive functioning. Importantly, the effects of concussion exposure on PCS varied as a function of player status. More specifically, extent of concussion exposure was associated with increased memory complaints and overall PCS endorsements in a dose-dependent manner for retired and older recreational players, but not for those who were younger and playing at more competitive levels. Future work should systematically evaluate the constituent participant factors that may influence differential concussion outcomes.},
keywords = {*Brain Concussion/co [Complications], *COGNITION, *Cognition Disorders/et [Etiology], *Football/in [Injuries], adult, Age Factors, aged, Brain Concussion/di [Diagnosis], Female, Humans, Male, middle aged, Neuropsychological Tests, Predictive Value of Tests, REGRESSION analysis, Surveys and Questionnaires, Trauma Severity Indices},
pubstate = {published},
tppubtype = {article}
}